2025-04-14_item_4.20_accept_public_improvements_constructed_by_dss_company_for_cip_ps_24-31_and_ratify_cco_no._4

ITEM 4. 20

CITY MANAGER' S REPORT
APRIL 14, 2025 CITY COUNCIL REGULAR MEETING
ITEM: ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY

DSS COMPANY DBA KNIFE RIVER CONSTRUCTION

FOR CONSTRUCTION OF YOSEMITE AVENUE
PAVEMENT REHABILITATION, CIP PS 24- 31, RATIFY
CONTRACT CHANGE ORDER NO. 4, AND APPROVE

BUDGET AMENDMENT
RECOMMENDATION: Adopt Resolution to Accept Public Improvements Constructed by DSS Company dba Knife River
Construction for Construction of Yosemite Avenue
Pavement Rehabilitation CIP PS 24- 31, Ratify City
Manager' s
Action to Execute Contract Change Order
No. 4, Approve Budget Amendment, and Authorize
the Filing of a Notice of Completion, Release of
Contract Retention, and Release of Performance and
Payment Bonds
SUMMARY:

DSS Company dba Knife River Construction ( Knife River) completed construction of Capital Improvement Project ( CIP) PS 24- 31 for Yosemite Avenue Pavement Rehabilitation ( Project). The Project scope of work included the installation of tack coat, glasgrid, 3" of hot mix asphalt overlay with shoulder backing, and thermoplastic striping on Yosemite Avenue from State Route ( SR) - 120 to easterly City limits.

On September 16, 2024, staff used the construction contingency to process Contract Change Order ( CCO) No. 1 to complete digout repairs at the pavement subbase layer for portions of the roadway that were severely damaged. On October 14, 2024, City Council approved CCO No. 2 and a budget amendment for installation of additional pavement reinforcing fabric to improve the pavement structural resistance to heavy traffic loads. CCO No. 3 was also processed for adjustments to digout repairs, contract quantities and unit costs.

The Project location was extended to include damaged pavement areas outside of the original scope of work. Extending the project limits resulted in CCO No. 4 for 175, 431 to add pavement overlay, shoulder backing, manhole cover adjustments, and additional signing and striping quantities. To avoid any delay in completing the Project, CCO No. 4, the City Manager executed CCO No. 4. Staff is requesting Council ratify the City Manager' saction to execute CCO No. 4 with Knife River for $ 175, 431.

The awarded contract was in the amount of $ 872, 030. During construction, contract change orders totaling $ 464, 85 were issued and additional permitting fees in the amount of $ 2,00 were processed for a total construction cost of $ 1, 339, 075. The approved budget amendment increased the Project funding by $ 223, 000 for a total CITY MANAGER' SREPORT PAGE 2
APRIL 14, 2025 CITY COUNCIL REGULAR MEETING

ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY DSS COMPANY DBA

KNIFE RIVER CONSTRUCTION FOR CONSTRUCTION OF YOSEMITE AVENUE PAVEMENT REHABILITATION, CIP PS 24- 31, RATIFY CONTRACT CHANGE ORDER NO. 4, AND APPROVE BUDGET AMENDMENT
construction budget of $ 1,82, 230. Staff is requesting Council approve a budget amendment transferring $ 156, 845 from the General Fund Street Repair Reserves 1010) to the CIP Project Fund ( 3310) to fund the difference of the total construction cost.

Staff inspected and the City Engineer deemed the improvements complete and in accordance with the approved plans and specifications. Knife River has submitted lien releases, confirming all sub -contractors and suppliers have been paid in full, and a one- year maintenance bond ( based on 10% of the construction contract) for the improvements to be accepted.

Staff also requests City Council accept the improvements constructed by Knife River for the Project, authorize the filing of a Notice of Completion with the San Joaquin County Clerk, release of contract retention to Knife River in the amount of $ 66, 844 within forty-ive (45) days after the recording of the Notice of Completion, release of performance and payment bonds.

BACKGROUND:

On July 8, 2024, City Council awarded a construction contract to Knife River for construction of the Project to repair the existing deteriorating pavement surface on Yosemite Avenue from SR - 120 to easterly City limits. The scope of work consisted of installing tack coat, glass grid, 3" of hot mix asphalt overlay with shoulder backing, and thermoplastic striping.

During construction, contract change orders totaling $464, 85 were issued for a final contract amount of $ 1, 336, 875. The construction costs referenced below capture all expenditures.

A. Construction Contract Amount
B. Approved Change Order 1
C. Approved Change Order 2
D. Approved Change Order 3
E. Approved Change Order 4
F. Miscellaneous / Permitting Fees
Total Construction Costs
872, 030
61, 575
222, 414
5, 425
175, 431
2,00
1, 339, 075
Knife River completed the construction of the Project. Staff inspected the improvements and the City Engineer deemed the improvements complete and in accordance with the approved plans and specifications. Upon acceptance of the improvements, the performance and payment bonds ( Bond No. 190- 055- 594- 108032785) will be released and replaced with a warranty bond ( Bond No. 190 -055- 594 -W/ 108032785 -W, $ 133, 688). The warranty bond covers any repairs or CITY MANAGER' SREPORT PAGE 3
APRIL 14, 2025 CITY COUNCIL REGULAR MEETING

ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY DSS COMPANY DBA

KNIFE RIVER CONSTRUCTION FOR CONSTRUCTION OF YOSEMITE AVENUE PAVEMENT REHABILITATION, CIP PS 24- 31, RATIFY CONTRACT CHANGE ORDER NO. 4, AND APPROVE BUDGET AMENDMENT
replacements that become necessary during the one- year period, beginning with this acceptance, due to defective materials or workmanship in connection with the completed improvements. Knife River has also provided the necessary lien releases for the materials supplied and completed work.

Staff is requesting City Council accept the public improvements constructed by Knife River for the Project. Staff also requests City Council authorize the filing of a Notice of Completion with the San Joaquin County Clerk, the release of contract retention to Knife River in the amount of $ 66, 844 within forty-ive (45) days after the recording of the Notice of Completion, and the release of performance and payment bonds.

REASON FOR RECOMMENDATION:

The project was completed by Knife River pursuant to the contract documents dated July 8, 2024. Staff inspected the improvements and the City Engineer deemed the improvements complete and in accordance with the approved plans and specifications. The performance and payment bonds ( Bond No. 190- 055- 594- 108032785) will be released and replaced with a one- year warranty bond ( Bond No. 190 -055 -594 -W/ 108032785 -W, $ 133, 688) upon City Council' s acceptance of the improvements.

FISCAL IMPACT:

The awarded contract was in the amount of $ 872, 030. During construction, contract change orders totaling $ 464, 85 were issued and additional permitting fees in the amount of $ 2,00 were processed for a total construction cost of $ 1, 339, 075. The approved budget amendment increased the Project funding by $ 223, 000 for a total construction budget of $ 1,82, 230. Staff requests Council approve a budget amendment to transfer $ 156, 845 from the General Fund Street Repair Reserves 1010) to the CIP Project Fund ( 3310) as follows:

Decrease Street Repair Reserves
1010- 251- 03-0
Increase Transfer Out
1010- 9900-90- 9010
Increase Transfer In
3310- 9900- 393- 0000 PS 24- 31
Increase Appropriation
3310- 8000- 420- 10 PS 24- 31
156, 845
156, 845
156, 845
156, 845
CITY MANAGER' S REPORT PAGE 4
APRIL 14, 2025 CITY COUNCIL REGULAR MEETING

ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY DSS COMPANY DBA

KNIFE RIVER CONSTRUCTION FOR CONSTRUCTION OF YOSEMITE AVENUE PAVEMENT REHABILITATION, CIP PS 24- 31, RATIFY CONTRACT CHANGE ORDER NO. 4, AND APPROVE BUDGET AMENDMENT
ATTACHMENTS:

A. Resolution to Accept Public Improvements Constructed by DSS Company dba Knife River Construction for Construction of Yosemite Avenue Pavement Rehabilitation CIP PS 24- 31, Ratify City Manager' s
Action to Execute Contract
Change Order No. 4, Approve Budget Amendment, and Authorize the Filing of a Notice of Completion, Release of Contract Retention, and Release of Performance and Payment Bonds
B. Yosemite Avenue Pavement Rehabilitation, CIP PS 24- 31 Contract Change Order No. 4
C. Notice of Completion - Yosemite Avenue Pavement Rehabilitation, CIP PS 24- 31 CITY MANAGER' S REPORT PAGE 5
APRIL 14, 2025 CITY COUNCIL REGULAR MEETING

ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY DSS COMPANY DBA

KNIFE RIVER CONSTRUCTION FOR CONSTRUCTION OF YOSEMITE AVENUE PAVEMENT REHABILITATION, CIP PS 24- 31, RATIFY CONTRACT CHANGE ORDER NO. 4, AND APPROVE BUDGET AMENDMENT
APPROVALS:
o'f- 03 - 2426'
Angel arca Date
Assistant Engineer
Brad Taylor
City E gineer
Cari Jam
Finance Li rector
Date
Date
Michael King Date
Assistant City Manager
y• 2 • Zo2S
v/ 31gogs
l•Z• 2026
V L. Le) Z
Salvador Navarrete Date
City Attorney
Stephen J. Salvatore Date
City Manager
RESOLUTION NO. 25 -

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF LATHROP

TO ACCEPT PUBLIC IMPROVEMENTS CONSTRUCTED BY DSS COMPANY DBA

KNIFE RIVER CONSTRUCTION FOR CONSTRUCTION OF YOSEMITE AVENUE ACTION

PAVEMENT

TO EXECUTE

REHABILITATION

CONTRACT
CIP
CHANGE
PS 24- 31,
ORDER
RATIFY
NO. 4, APPROVE

CITY MANAGER' S
BUDGET

AMENDMENT, AND AUTHORIZE THE FILING OF A NOTICE OF COMPLETION,

RELEASE OF CONTRACT RETENTION, AND RELEASE OF PERFORMANCE AND

PAYMENT BONDS
WHEREAS, DSS Company dba Knife River Construction ( Knife River) completed construction of Capital Improvement Project ( CIP) PS 24- 31 for Yosemite Avenue Pavement Rehabilitation ( Project); and
WHEREAS, the Project scope of work included the installation of tack coat, glasgrid, 3" of hot mix asphalt overlay with shoulder backing, and thermoplastic striping on Yosemite Avenue from State Route ( SR) - 120 to easterly City limits; and WHEREAS, on September 16, 2024, staff used the construction contingency to process Contract Change Order ( CCO) No. 1 to complete digout repairs at the pavement subbase layer; and
WHEREAS, on October 14, 2024, City Council approved CCO No. 2 and a budget amendment for installation of additional pavement reinforcing fabric to improve the pavement structural resistance to heavy traffic loads. CCO No. 3 was also processed for adjustments to digout repairs, contract quantities and unit costs.; and
WHEREAS, the Project location was extended to include damaged pavement areas outside of the original scope of work. Extending the project limits resulted in CCO No. 4 for $ 175, 431 to add pavement overlay, shoulder backing, manhole cover adjustments, and additional signing and striping quantities; and WHEREAS, to avoid any delay in completing the Project, the City Manager executed CCO No. 4. Staff is requesting Council ratify the City Manager' saction to execute CCO No. 4 with Knife River for $ 175, 431; and
WHEREAS, staff inspected and the City Engineer deemed the improvements complete and in accordance with the approved plans and specifications; and WHEREAS, Knife River has submitted lien releases, confirming all subcontractors and suppliers have been paid in full, and a one- year maintenance bond based on 10% of the construction contract) for the improvements to be accepted; and
WHEREAS, staff also requests City Council accept the improvements constructed by Knife River for the Project, authorize the filing of a Notice of Completion with the San Joaquin County Clerk, release of contract retention to Knife River in the amount of $ 66, 844 within forty-ive (45) days after the recording of the Notice of Completion, and release of performance and payment bonds; and WHEREAS, the awarded contract was in the amount of $ 872, 030. During construction, contract change orders totaling $ 464, 85 were issued and additional permitting fees in the amount of $ 2,00 were processed for a total construction cost of $ 1, 339, 075. The approved budget amendment increased the Project funding by 223, 000 for a total construction budget of $ 1,82, 230. Staff requests Council approve a budget amendment to transfer $ 156, 845 from the General Fund Street Repair Reserves ( 1010) to the CIP Project Fund ( 3310) as follows:

Decrease Street Repair Reserves
1010- 251- 03-0
Increase Transfer Out
1010- 9900-90- 9010
Increase Transfer In
3310- 9900- 393- 0000
Increase Appropriation
3310- 8000- 420- 10
PS 24- 31
PS 24- 31
156, 845
156, 845
156, 845
156, 845
NOW THEREFORE, BE IT RESOLVED, that the City Council of the City of Lathrop does hereby accept the public improvements constructed by Knife River for Yosemite Avenue Pavement Rehabilitation, CIP PS 24- 31; and BE IT FURTHER RESOLVED, that the City Council of the City of Lathrop hereby ratifies City Manager' sAction to Execute Contract Change Order No. 4 with Knife River for Yosemite Avenue Pavement Rehabilitation, CIP PS 24- 31; and BE IT FURTHER RESOLVED, that the City Council of the City of Lathrop authorizes the filing of the Notice of Completion with the San Joaquin County Clerk, release of the contract retention to Knife River, in the amount of $ 66, 844, within forty-ive (45) days after the recording of the Notice of Completion, and release of the performance and payment bonds; and
BE IT FURTHER RESOLVED, the City Council of the City of Lathrop hereby approves a budget amendment transferring $ 156, 845 from the General Fund Street Repair Reserves ( 1010) to the CIP Project Fund ( 3310) as detailed above.

The foregoing resolution was passed and adopted this 14th day of April 2025, by the following vote of the City Council, to wit:

AYES:

NOES:

ABSENT:

ABSTAIN:

Paul Akinjo, Mayor
ATTEST: APPROVED AS TO FORM:

Teresa Vargas, City Clerk Salvador Navarrete, City Attorney Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641 Attachment B

BALANCING CONTRACT CHANGE ORDER SUMMARY
CIP PS 24- 31 Yosemite Avenue Pavement Rehabilitation
Bid Item List Quantity
DSS Company dba Knife River Construction

ORIGINAL ESTIMATED COST FINAL COST
Unit J Unit Cost I Subtotal Quantity _ Subtotal I Difference 1 Mobilization, Bonds & Insurance 1 LS 81, 000. 81000. 00 1. 00 81, 000. 0.0 2 Traffic Control 1 LS 50, 800. 0 50, 800. 0 1. 00 50, 800. 0 0.0 3 Lower and Raise Valve Covers 2 EA 2, 650. 0 5, 300. 0 17. 00 45, 050. 39, 750. 0 4 Lower and Raise Monument Covers 2 EA 2, 650. 0 5, 300. 0 6. 00 15, 900. 0 10, 600. 0 5 Grind Out and Dispose 3" AC 112, 900 SF 0. 44 49, 676. 00 119, 365. 00 52,20. 6 2, 844. 60 6 Digouts as Shown Per Plans 2, 500 SF 7. 00 17, 500. 0 2, 500. 0 17, 500. 0 0.0 7 Place HMA @ 3" Depth / Single Lifts 3, 550 TON 101. 08 358, 834. 00 4, 736.0 478, 75. 64 119, 951. 64 8 Install Tensar 8502 GlasGrid 68, 400 SF 1. 79 122, 436. 00 68, 400. 0 122, 436. 00 0.0 9 Shoulder Backing 815 TON 51. 00 41, 565. 00 380. 80 19, 420. 8 22, 144. 20 10 Thermoplastic Striping - Caltrans 7, 975. 80
Standard
Detail 22
3, 430 LF 5. 40 18, 522. 00 4, 907. 00 26, 497. 80
11 Thermoplastic Striping - Caltrans Std. Pln.

A20, Detail 27B
8, 175 LF 2. 00 16, 350. 0 8,20. 0 17, 640. 0 1, 290. 0 12 Thermoplastic Striping - Caltrans Std. Pln.

A20, Detail 38
1,20 LF 3. 40 3, 808. 00 1, 051.0 3, 573. 40 234. 60
13 Thermoplastic Striping - Caltrans Std. Pln.

A20, Detail 39
5,15 LF 2. 80 15, 442. 00 5,21. 00 15, 458. 80 16. 80
14 Thermoplastic Striping - Caltrans Std. Pln.

A20, Detail 39A
610 LF 2. 80 1, 708. 00 400. 00 1,20. 0 588 00
15 Thermoplastic Striping - 8" White/ Yellow
Line Diagonal
300 LF 4. 52 1, 356. 00 534. 00 2, 413. 68 1, 057. 68
16 Methyl methacrylate ( MMA) Green
Enhancement
2, 460 SF 18. 65 45, 879. 00 2,60. 0 42, 149. 00 3, 730. 0 17 Thermoplastic Striping - 12" White Line 75 LF 13. 56 1, 017.0 350. 00 4, 746. 00 3, 729. 00 18 Thermoplastic Striping - Yield Line 15 LF 67. 80 1, 017.0 15. 00 1, 017.0 0.0 19 Thermoplastic Marking - Type I Arrow ( 24')
Thru)
2 EA 565. 00 1,30. 0 2. 00 1,30. 0 0.0
20 Thermoplastic Marking - Type IV Arrow
Left or Right)
17 EA 339. 00 5, 763. 00 17. 00 5, 763. 00 0.0
21 Thermoplastic Marking - BIKE LANE,

ONLY BUS, STOP
9 EA 678. 00 6, 102. 00 9. 00 6, 102. 00 0.0
22 Insert Blue RPM @ Fire Hydrant 5 EA 57. 00 285. 00 5. 00 285. 00 0.0 23 Signage as Shown per Plans 1 LS 21,40. 0 21,40. 0 1. 00 21,40. 0 0.0 Subtotal 872, 030. Subtotal 1, 032, 548. 72 160, 518. 72 Contract Change Orders
CCO 1 6" Digouts Revisions 1 LS 61, 575. 00 61, 575. 00 1 61, 575. 00 0.0 CCO 2 Tensar Glasgrid 1 LS 222, 414. 00 222, 414. 00 1 222, 414. 00 0.0 CCO 3 Final Digout Placement 1 LS 5, 425. 00 5, 425. 00 1 5, 425. 00 0.0 CCO 4
Additional Striping Removal &
Remobilization Fees 1 LS 1 14, 911. 70 14, 911. 70
Subtotal 289, 414. 00 Subtotal 304,25. 70 14, 911. 70
Subtotal Bid Item List+ CCO 1,61, 444. 00 Subtotal Contract Change + CCO 175, 430.2

SUMMARY
Total Balancing Change Order 175, 430.2
Original Contract Price
Approved Contract
Contract Bid Items Changes
Contract Change Orders
Total for extra work
872, 030.
872, 030.
160, 518. 72
304,25. 70
464, 84. 42
Total Contract Amount After Change Orders $ 1, 336, 874. 42 Approved Contingency
Approved Supplemental Contingency
Total Approved Contingency
87, 203. 00
222, 414. 00
309, 617. 00
Remaining Contingency After Change Orders -$ 155, 227. 42 Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641 Acceptance by Contractor:

I have examined the quantities of contract items and amounts indicated as payment for extra work and deductions on the proposed final estimate. I agree to accept the total of $ 1, 336, 874. 42as indicated, as total amount earned for all work performed on the above contract, except as may be indicated below.

Exceptions ( check one)
x None
As indicated on the attached letter dated:
ny dba Knife River Construction
leUXOLG AtAYt1U. t/') 3/ 28/025
By Revae Martnezproject Manager
Date
City of Lathrop
Re mend
Project Manager
4 - 1 - 2S
Signed by:
rbbt 3/ 28/025
030 60672080486...

BY: Rod Getty
Rev
vice President] feral Manager
Date Brad Tfylor, City Engineer
Depa nt Budge nalyst Date
Approved By:

Steph ore, City Manager
i4BZ2
Date
Approve As to Form By: ,
Salvador Navarrete, City Attorney Date

CHANGE ORDER JUSTIFICATION
Yosemite Avenue Pavement Rehabilitation
CIP # PS 24- 31
CHANGE ORDER No. 4
Date:
3/ 19/ 25
Resolution: 24- 5652
Project Name: Yosemite Avenue Pavement Rehabilitation
Contractor: DSS Company dba Knife River Construction
CIP: PS 24- 31
Contract Amount : $ 872, 030
Contingency Amount: $ 87, 200
Lathrop City Council awarded a construction contract and authorized the City Manager to approve change orders up to the specified project contingency amount of $ 87, 200. 0 if needed.

This change order #4 combines PCOs 4, 5, and 6 which consist of the following modifications to the original contract. Due to limit changes in the project scope, additional striping removal and replacement was needed. Construction in the vicinity of the railroad tracks was phased to accommodate permitting requirements from UPRR. As a result, remobilization fees were added to the contract cost. Extending the project limits included the addition of pavement overlay, shoulder backing and iron adjustments.

For the reasons detailed above, Engineering is requesting City Manager to approve Change Order No. 4 in order to meet the expectations of the project as intended.

Submitted by: 4 px-(" _ &
Project Manager
Approved by: IV - ad P. E., City Engineer
3 24-5

Page 4 of 4 ends

Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641 EXHIBIT " 21._"

KNIFE RIVER

CONSTRUCTION

AN MDU RESOURCES COMPANY

PROPOSED CHANGE ORDER
NO. 005
SUBJECT: Additional Striping Removal DATE: 10/ 23/4
PROJECT: Yosemite Ave Pavement Rehabilitation JOB NO: 57241844 TO: City of Lathrop - Department of Public Works
390 Towne Centre Drive
Lathrop, CA 95330
ATTN: Ken Reed
FROM: Revae Martinez
Additional striping removal at areas that were originally called out to receive new pavement on plans. 001 Additional Striping Removal
10% for Subcontracted Work
1 LS 11, 927. 00 11, 927. 00
1,92. 70
TOTAL AMOUNT $ 13,19. 70

APPROVAL
BY:

DATE:

Ken Reed
BY:

DATE:

ZaLte
Revae Martinez
10/ 23/024
655 W. Clay St., P. O. Box 6099 • Stockton, CA 95206 • ( 209) 948- 0302 • Fax ( 209) 948- 6652 Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641

11. SIERRA TRAFFIC MARKINGS, INC.

SIERRA TRAFFIC MARKINGS, INC.
9725 Del Road Suite 8 Roseville, Ca. 95747
916) 774- 9080 Office ( 916) 774- 9088 Fax
TO
Knife River
1764 Skyway
Chico, CA 95928
Attn:

Office:

Fax:

Revae Martinez
530- 891- 6555
530- 894- 6220
Customer E- mail: revae. martinez@kniferivercom
CHANGE ORDER #
PROJECT NAME:

PROJECT ADDRESS:

CITY:

CUSTOMER JOB #:

AUTHORIZED BY:

ESTIMATE #: 24- 1068A
Date 10/ 22/024
Yosemite Ave Pave Rehab
Lathrop, CA
57241844
Andre Acia
The original contract agreement between Sierra Traffic Markings, Inc. and the contractor named above is here by modified and amended by the following deviations from the original contract.

DESCRIPTION OF CHANGE OR MODIFICATION

ITEM QTY UNIT DESCRIPTION TOTAL
1 35
2 7
2, 640
3, 465
LS
LF
EA
EA
SF
LF
CHANGE ORDER # 1
Additional Removal In Areas Not Overlaid Due To Limit Changes In Scope Removal of Stripes & Markings Prior to Restripe12" White Limit Line Arrows - Type III
Bike & Arrows Symbols
Green MMA Bike Lane
Line Removal
NOTE: To Be Completed W/ Contract Work Or Mobilization Fees Will Apply** NOTE: This change order EXCLUDES the Following Items:

A) All Surface Sealer After Removal ( Seal Coat, Fog Seal & Slurry Seal) For questions or concerns regarding this change order please contact Andre Acia at 916- 759- 4474 (cell) or andre@sierratrafficmarkings. com 11, 927. 00
CHANGE ORDER TOTAL 11, 927. 00
It is mutually agreed that for such change the contract price is increased by $ 11, 927. 00 All provisions of the original contract and agreement shall remain in full force and effect, without change because of above deviations. All change orders must be approved before Sierra Traffic Markings can complete any additional work requested or required. Upon approval of all changes above, please sign, date and return back Sierra Traffic Markings, Inc..

Thank You,
Sierra Traffic Markings, Inc. Upon Approval Please Sign Below Authorized Name & Signature Date Accepted
Knife River
1764 Skyway
Chico, CA 95928
LEGEND R1- 1
SIZE:
36"
X
36"
QTY:
1 NO ANYPARKING TIME R26A (
CA)
SIZE:
24"
X
QTY :
30"
14 W3- 1
SIZE:
48"
X
48"
QTY:
1 SPEED
LIM
IT 45 R2- 1 (
45)
SIZE:
36"
X
48"
QTY:
3 NOTES
FOR
CONTRACTOR:

1. CONTRACTOR
TO
VERIFY
ALL

DIMENSIONS
AND

LOCATIONS

2. ALL

STRIPING
TO
FOLLOW

CALTRANS

STANDARD

DETAILS

3. ALL
SIGNS
TO
COMPLY
WITH
MUTCD

STANDARDS
SPEED ENFORCED BY RADAR R48 (
CA)
SIZE:
24"
X
30"
Q
TY:
3 W1 -
8R
SIZE:
30"
X
QTY ; 36"
3 NEW

ASPHALT
G66- 56 (
CA)
SIZE:
36"
X
36"
QTY:
1 M6- 6
MOD
SIZE:
21"
X
15"
QTY: 1
R3- 8
MOD
SIZE:

VARIES QTY:
1 t
ONLY
ONLY
ONLY
R61- 34
MOD
SIZE:

VARIES QTY:
1 AVENYOSEMITE
UE

PAVEMENT REHABILITATION CIP
PS
24- 31

SIGNING
AND

STRIPING

REVISIONS
NO,
BY
DA
TE
DES

CRIPTION
DRAW
N
BY:

A .

CHECKED
BY:

B .

PRO) .

MGR.:

DATE:

MAY
SCALE:

VARIES
FILE
NO .:

CIP
PS
Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641 KNCONS1 FE

TRUCTIORIVNER AN MDU RESOURCES COMPANY

PROPOSED CHANGE ORDER
NO. 006
SUBJECT: Remobilization Fees DATE: 11/ 25/4
PROJECT: Yosemite Ave Pavement Rehabilitation JOB NO: 57241844 TO: City of Lathrop - Department of Public Works
390 Towne Centre Drive
Lathrop, CA 95330
ATTN: Ken Reed
FROM: Revae Martinez
Remobilization fees associated with phasing job to prioritize work withing the railroad ROW while awiting additional GlasGrid delivery for completion of the remainder od the project. 001 Grinder
002 GlasGrid / Tack Truck
003 Paver
1 LS
1 LS
1 LS
575. 00
575. 00
642. 00
575. 00
575. 00
642. 00
TOTAL AMOUNT $ 1, 792. 00

APPROVAL
BY:

DATE:

Ken Reed
BY:

DATE:

Zce- ote
Revae Martinez
11/ 25/024
655 W. Clay St., P. O. Box 6099 • Stockton, CA 95206 • ( 209) 948- 0302 • Fax ( 209) 948- 6652 Docusign Envelope ID: 2FF9B5D5- DA4D- 4713- AB43- 319BF615C641

KNIFE RIVER

CONSTRUCTION

AN MDU RESOURCES COMPANY

PROPOSED CHANGE ORDER
NO. 007
SUBJECT: Final Balancing Change Order
PROJECT Yosemite Ave Pavement Rehabilitation
TO: City of Lathrop - Department of Public Works
390 Towne Centre Drive
Lathrop, CA 95330
ATTN: Ken Reed
DATE: 11/ 26/4
JOB NO: 57241844
FROM: Revae Martinez
D
Final balancing change order to account for underruns and overruns on the original contract quantities as noted below. 3 Lower & Raise Valve Covers
4 Lower & Raise Monument Covers
5 Grind Out & Dispose 3" AC
7 Place HMA @ 3" Depth / Single Lift
9 Shoulder Backing
10 Thermoplastic Striping - Caltrans Std A20 Dtl 22
11 Thermoplastic Striping - Caltrans Std A20 Dtl 27B
12 Thermoplastic Striping - Caltrans Std A20 Dtl 38
13 Thermoplastic Striping - Caltrans Std A20 Dtl 39
14 Thermoplastic Striping - Caltrans Std A20 Dtl 39A
15 Thermoplastic Striping - 8" White/ Yellow Line Diagonal 16 Methyl Methacrylate ( MMA) Green Enhancement
17 Thermoplastic Striping - 12" White Line
2 2
112, 900
3, 550
815
3, 430
8, 175
1,20
5,15
610
300
2, 460
75 EA
EA
SF
TN
TN
LF
LF
LF
LF
LF
LF
SF
LF
17 15. 00 $ 2, 650. 0
6 4. 00 $ 2, 650. 0
119, 365 6, 465. 00 $ 0. 44
4, 736. 1,86. 70 $ 101. 08
380. 8 ( 434. 20) $ 51. 00
4, 907 1, 477. 00 $ 5. 40
8,20 645. 00 $ 2. 00
1, 051 ( 69. 00) $ 3. 40
5,21 6. 00 $ 2. 80
400 ( 210. 00) $ 2. 80
534 234. 00 $ 4. 52
2,60 ( 200. 00) $ 18. 65
350 275. 00 $ 13. 56
39, 750. 0
10, 600. 0
2, 844. 60
119, 951. 64
22, 144. 20)
7, 975. 80
1, 290. 0
234. 60)

16. 80
588. 00)
1, 057. 68
3, 730. 00)
3, 729. 00
TOTAL AMOUNT $ 160, 518. 72

APPROVAL
BY:

Ken Reed
DATE:

BY:

DATI
Revae Martinez 6.
11/ 26/024
655 W. Clay St., P. O. Box 6099 • Stockton, CA 95206 • ( 209) 948- 0302 • Fax ( 209) 948- 6652 1 ®
Accwo CERTIFICATE LIABILITYOF INSURANCE

DATE ( MM/ DD/ YYYY)
01/8/ 2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy( ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement( s).

PRODUCER

MARSH USA LLC
333 South 7th Street, Suite 1400
Minneapolis, MN 55402- 200
CN103060364- DSS- GAWX- 25-6

CONTACT
NAME: Marsh I U. S. Operations & Technology

PHONE FAX
A/ C. No. Ext): 866- 96- 4664 ( A/ C, No): 212- 948- 5382

E- MAIL
ADDRESS: MinneaPolis. CertRe questC marsh. com
INSURER( S) AFFORDING COVERAGE NAIC #
INSURER A : Liberty Mutual Fire Ins Co 23035

INSURED
DSS Company
dba Knife River Construction
655 West Clay Street
Stockton, CA 95206- 1722
INSURER B : N/ A
N/ A
INSURER C :

INSURER D :

INSURER E :

INSURER F :

CERTIFICATE NUMBER: CHI -010717490- 03 REVISION NUMBER:
v

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR

LTR TYPE OF INSURANCE
ADDL
INSD
SUBR

WVD POLICY NUMBER

POLICY EFF

MM/ DD/ YYYY)

POLICY EXP

MM/ DD/ YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY TB2641446115025 01/ 2025 01/ 2026 EACH OCCURRENCE 5, 000,00

DAMAGE TO RENTED
CLAIMS -MADE X OCCUR PREMISES ( Ea occurrence) 1, 000,00 MED EXP (Any one person) 10, 000
PERSONAL & ADV INJURY 5, 000,00
GEN' LAGGREGATE GENERAL AGGREGATE 5, 000,00
POLICY
OTHER:

LIMIT APPLIES
Te.,
PER:

LOC PRODUCTS - COMP/ O AGG 5, 000,00

A AUTOMOBILE
X

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
AS2641446115035 01/ 2025 01/ 2026 COMBINED SINGLE LIMIT Ea accident) 5, 000,00
BODILY INJURY ( Per person)
BODILY INJURY ( Per accident)

PROPERTY DAMAGE
Per accident)

UMBRELLA LIAB

EXCESS LIAB
OCCUR

CLAIMS - MADE

EACH OCCURRENCE

AGGREGATE
DEO RETENTION $
A
A

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

ANYPROPRIETOR/ PARTNER/ EXECUTIVE
OFFICER/ MEMBER EXCLUDED? N
Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/ A
WA264D446115365 ( AOS)
WC2641446115065( MN)
01/ 2025
01/ 2025
01/ 2026
01/ 2026
X STATUTE OTHER
E. L. EACH ACCIDENT 1, 000,00
E. L. DISEASE - EA EMPLOYEE 1, 000,00
E. L. DISEASE - POLICY LIMIT 1, 000,00
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ( ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Yosemite Avenue Pavement Rehabilitation CIP PS 24- 31 / KRC Job #57241844.

City of Lathrop, its officers, City Council, boards and commissions and members thereof, its employees and agents is/ are included as additional insured under general liability where required by written contract and does not include professional liability coverage. Blanket Additional Insured for Automobile Liability is included where required by written contract. Auto Liability: Primary and Non- contributory applies to the insured' s owned autos where required by written contract. Primary and Non -Contributory applies for General Liability where required by written contract.

ELLATION
City of Lathrop
390 Towne Center Drive
Lathrop, CA 95330

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

AUTHORIZED REPRESENTATIVE
of Marsh USA LLC
ACORD 25 (2016/ 03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN103060364
LOC #: Minneapolis
ACO DR ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY

MARSH USA LLC

NAMED INSURED
DSS Company
dba Knife River Construction
655 West Clay Street
Stockton, CA 95206- 1722

POLICY NUMBER

CARRIER NAIC CODE
EFFECTIVE DATE:

ADDITIONAL REMARKS

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Blanket Waiver of Subrogation, where allowed by law and required by written contract, applies for General Liability, Automobile Liability, and Workers Compensation.

General liability policy includes contractual liability but only to the extent provided in the policy.

No explosion, collapse or underground damage exclusion is included on the general liability policy.

Separation of insureds is included on the policy form CG 00 01 12 07 as follows: except with respect to the limits of insurance and any rights or duties specifically assigned in this coverage part to the first named insured, this insurance applies: As if each named insured were the only named insured; and Separately to each insured against whom claim is made or " suit" is brought.

The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: TB2- 641- 46115- 02 COMMERCIAL GENERAL LIABILITY CG 20 26 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - DESIGNATED

PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Name Of Additional Insured Person( s) Or Organization( s):

Any person or organization with whom you have agreed in writing prior to a loss, to provide liability insurance Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II — Who is An Insured is amended to
include as an additional insured the person( s) or
organization( s) shown in the Schedule, but only
with respect to liability for " bodily injury", "property damage" or " personal and advertising injury"
caused, in whole or in part, by your acts or
omissions or the acts or omissions of those acting
on your behalf:

1. In the performance of your ongoing operations;
or

2. In connection with your premises owned by or
rented to you.

However:

1. The insurance afforded to such additional
insured only applies to the extent permitted by
law; and

2. If coverage provided to the additional insured is
required by a contract or agreement, the
insurance afforded to such additional insured
will not be broader than that which you are
required by the contract or agreement to provide
for such additional insured.

B. With respect to the insurance afforded to these
additional insureds, the following is added to
Section III — Limits Of Insurance:

If coverage provided to the additional insured is
required by a contract or agreement, the most we
will pay on behalf of the additional insured is the
amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of
insurance;
whichever is less.

This endorsement shall not increase the applicable
limits of insurance.

CG 20 2612 19 Insurance Services Office, Inc., 2018 Page 1 of 1 Policy Number TB2- 641- 46115- 02
Issued by Liberty Mutual Fire Insurance Co.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the followings:

BUSINESS AUTO COVERAGE PART

MOTOR CARRIER COVERAGE PART

GARAGE COVERAGE PART

TRUCKERS COVERAGE PART

EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART

SELF -INSURED TRUCKER EXCESS LIABILITY COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PART

EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule of this endorsement. We will send notice to the email or mailing address listed above at least 10 days. or the number of days listed above, if any. before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.

B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy.

All other terms and conditions of this policy remain unchanged.

Schedule
Name of Other Person( s) I Email Address or mailing address: Number Days Notice:

Organization( s):

Includes copyrighted material of Insurance Services Office. Inc.. with its permission.

Page 1 of 1 ends

COMMERCIAL GENERAL LIABILITY
CG 2001 1219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

PRIMARY AND NONCONTRIBUTORY -

OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance
Condition and supersedes any provision to the
contrary:

Primary And Noncontributory Insurance
This insurance is primary to and will not seek
contribution from any other insurance available to
an additional insured under your policy provided
that:
1) The additional insured is a Named Insured
under such other insurance; and
2) You have agreed in writing in a contract or
agreement that this insurance would be
primary and would not seek contribution
from any other insurance available to the
additional insured.

CG 20 01 1219 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: TB2- 641- 446115- 02 COMMERCIAL GENERAL LIABILITY CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US ( WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

ELECTRONIC DATA LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART

POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES

POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES

PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART

RAILROAD PROTECTIVE LIABILITY COVERAGE PART

UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS

SCHEDULE
Name Of Person( s) Or Organization( s):

As required by contract or agreement entered into prior to loss.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The following is added to Paragraph 8. Transfer Of
Rights Of Recovery Against Others To Us of
Section IV — Conditions:

We waive any right of recovery against the person( s)
or organization( s) shown in the Schedule above
because of payments we make under this Coverage
Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against
such person( s) or organization( s) prior to loss. This endorsement applies only to the person( s) or
organization( s) shown in the Schedule above.

CG 24 0412 19 Insurance Services Office, Inc., 2018 Page 1 of 1 POLICY NUMBER: AS2- 641- 44615- 03 COMMERCIAL AUTO
CA 20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED INSURED FOR

COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

This endorsement identifies person( s) or organization( s) who are " insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.

SCHEDULE
Name Of Persons) Or Organlzatlon( s):

Any person or organization where the named insured has agreed by written contract to include such person or organization as a designated insured.

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Each person ororganization shown in the Schedule is
an " insured" for Covered Autos LiabilityCoverage, but
only to the extent that person or organization qualifies as an " insured" under the Who Is An Insured provision
contained in Paragraph A. 1. of Section II - Covered
Autos Liability Coverage in the Business Auto and
Motor Carrier Coverage Forms and Paragraph D. 2. of
Section I - Covered Autos Coverages of the Auto
Dealers Coverage Form.

CA20481013 O Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AS2- 641- 46115- 03
Issued By: Liberty Mutual Fire Insurance Co.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

NOTICE OF CANCELLATION TO THIRD PARTIES
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE PART

MOTOR CARRIER COVERAGE PART

GARAGE COVERAGE PART

TRUCKERS COVERAGE PART

EXCESS AUTOMOBILE LIABILITY INDEMNITY COVERAGE PART

SELF - INSURED TRUCKER EXCESS LIABILITY COVERAGE PART

COMMERCIAL GENERAL LIABILITY COVERAGE PART

EXCESS COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/ COMPLETED OPERATIONS LIABILITY COVERAGE PART

LIQUOR LIABILITY COVERAGE PART
Schedule
Name
Organlzatlon( s):
of Other Person( s}I
Email Address or mailing
address:

Number
Days
Notice:

Per schedule of certificate holders
on file with the company
Per schedule of certificate holder
on file with the company
90 A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule above. We will send notice to the email or mailing address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.

All other terms and conditions of this policy remain unchanged.

Includes copyrighted material of Insurance Services Office, Inc. with its permission.

Page 1 of 1 ends

Policy Number. AS2- 641- 46115- 03
Issued by: Liberty Mutual Fire Insurance Co.

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

DESIGNATED INSURED - NONCONTRIBUTING
This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIERS COVERAGE FORM

TRUCKERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.

This endorsement identifies person( s) or organization( s) who are insureds" under the Who Is An Insured Provision ofthe Coverage Form. This endorsement does not alter coverage provided in the Coverage form.

Schedule
Name
Any person
ofPersons)
or organization
or Organlzatlons( s):
for which the Named Insured has agreed by written
contract executed prior to loss to furnish this endorsement.

Regarding Designated Contract or Project:

Each person ororganization shown in the Schedule of this endorsement is an " insured" for Liability Coverage, but only to the extent that person or organization qualifies as an " insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form.

The following is added to the Other Insurance Condition:

If you have agreed in a written agreement that this policy will be primary and without right of contribution from any insurance in force for an Additional Insured for liability arising out of your operations, and the agreement was executed prior to the " bodily injury" or " properly damage", then this Insurance will be primary and we will not seek contribution from such insurance.

Includes copyrighted material of Insurance Services Office, Inc., with its permission.

Page 1 of 1 ends

POLICY NUMBER: AS2- 641- 46115- 03 COMMERCIAL AUTO
CA 04 44 10 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM
With respectto coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

SCHEDULE
Name( s) Of Person( s) Or Organlsatlon( s):

If you are required by a written contract or agreement, which is executed before a loss, to waive your rights of recovery from others, we agree to waive our rights of recovery.

Premium: $ INCL
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The Transfer Of Rights Of Recovery Against
Others To Us condition does not apply to the
person( s) or organization( s) shown in the Schedule,
but only to the extent that subrogation is waived prior to the " accident" or the " loss" under a contract with that person or organization.

CA04441013 Insurance Services Office, Inc., 2011 Page 1 of 1

NOTICE OF CANCELLATION TO THIRD PARTIES
A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event does the notice to the third party exceed the notice to the first named insured.

Organization( s):

Name of Other Person( a) l
Schedule on file with the
Company
Schedule
Email Address or mailing address: Number Days Notice:

Schedule on file with the 90
Company
All other terms and conditions of this policy remain unchanged.

Issued by Liberty Mutual Fire Insurance Company 16586
For attachment to Policy No. WA2- 64D- 46115- 365 Effective Date Premium $ Issued to Knife River Corporation Endorsement No.

WC 99 20 75
Ed. 12/ 01/ 2016
2016 Liberty Mutual Insurance Page 1 of 1

B. This advance notication of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notification will not extend the policy cancellation date nor negate cancellation of the policy.

Organization( s):

Name of Other Person( s)1
Schedule on file with the
Company
Schedule
Email Address or mailing address:

Schedule on file with the
Company
All other terms and conditions of this policy remain unchanged.

Issued by Liberty Mutual Fire Insurance Company 16596
For attachment to Policy No. WC2- 641- 46115- 06
Number Days Notice:
90 Effective Date Premium $
Issued to Knife River Corporation Endorsement No.

WC 99 20 75
Ed. 12/ 0112016
2016 Liberty Mutual Insurance Page 1 of 1

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. ( This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.

Not applicable in Alaska
Schedule
Where required by contract or written agreement prior to loss and allowed by law.

In the states of Arizona, Colorado, Delaware, Idaho, Mississippi, Montana, South Dakota, the premium charge is 2% of the total manual premium, subject to a minimum premiumof $ 100 per policy.

In the states of Florida, Iowa, Nebraska, Nevada, Oregon, the premium charge is 1% of the total manual premium, subject to a minimum premium of 250 per policy.

Hawaii: The premium charge is $ 20, 172 and determined as follows: The premium charge for this endorsement is 1% of the total manual premium, subject to a minimum premium of $250 per poIicy. Delaware, Issued by Liberty Mutual Fire Insurance Company 16586
For attachment to Policy No. WA2- 64D- 44 115- 365 Effective Date Premium $ Issued to Knife River Corporation Endorsement No.

WC 00 0313
Ed. 04/1/ 1984
C 1983 National Council an Compensation Insurance. Page 1 of 1

Schedule
The waiver does not apply to any right to recover payments which the Minnesota Workers Compensation Reinsurance Association may have or pursue under M. S. 79. 36.

Where required by contract or written agreement prior to loss and allowed by law.

In the state of Minnesota, the premium charge is 2% of the total manual premium, subject to a minimum premium of $ 100 per policy.

Issued by Liberty Mutual Fire Insurance Company 16586
For attachment to Policy No. WC2- 641- 46115- 06 Effective Date Premium $ Issued to Knife River Corporation Endorsement No.

WC 00 0313
Ed. 04/1/ 1984
1983 National Council on Compensation Insurance. Page 1 of 1

RECORDING REQUESTED BY, AND
WHEN RECORDED MAIL TO:

CITY OF LATHROP
ATTN: CITY CLERK
390 TOWNE CENTRE DRIVE
LATHROP, CA 95330
Exempt from payment ofrecording fees ( GC 11922)
Attachment C

SPACE ABOVE THIS LINE FOR RECORDER' S USE

NOTICE OF COMPLETION
NOTICE IS HEREBY GIVEN:

1. That the interest or estate stated in paragraph 3 herein in the real property herein described is owned by:

NAME STREET AND NO. CITY STATE
City of Lathrop 390 Towne Centre Drive Lathrop CA 95330 If more than one owner of the interest stated, the name and address of each must be stated)

2. That the full name and address of the owner of said interest or estate, ifthere is only one owner, and that the full names and addresses of all the co - owners who own said interest or estate as tenants in common, as joint tenants, or otherwise, ifthere is more than one owner, are set forth in the preceding paragraph.

3. That the nature of the title of stated owner, or if more than one owner, then of the stated owner and co -owners is fee title (e.g. fee title, leasehold, joint tenancy, etc.).

4. That on the 14th day of April 2025 a work of improvement on the real property herein described was completed.

5. That the name ofthe original contractor, ifany, for said work ofimprovement was: DSS Company dba Knife River Construction

6. That the name and address of the transferor is:

NAME STREET AND NO.

DSS Company dba 655 West Clay Street
Knife River Construction

CITY STATE
Stockton CA 95206

7. That the real property herein referred to is situated in the City of Lathrop County of San Joaquin, State of California, and is described as follows:

CIP PS 24- 31 Yosemite Avenue Pavement Rehabilitation
That the undersigned has knowledge of the contents herein and states under penalty ofperjury that the foregoing is true and correct.

CITY OF LATHROP
By:

By:

Stephen J. Salvatore, City Manager Date
Teresa Vargas, City Clerk Date

CERTIFICATE OF ACCEPTANCE
This is to certify that the interest in real property conveyed by the NOTICE OF COMPLETION dated April 14, 2025 by DSS Company dba Knife River Construction to the City of Lathrop, a political corporation and/ or governmental agency, is hereby accepted by the undersigned officer or agent on behalf of the City Council pursuant to authority conferred by minute action of the City Council adopted on April 14, 2025, and the grantee consents to recordation thereof by its duly authorized officer.

Dated By
Stephen J. Salvatore, City Manager

Lathrop City CouncilApril 14, 2025

Lathrop City Council
April 14, 2025